title: Febrile neutropenia: significance of elaborated screening for respiratory viruses, and the comparison of different sampling methods, in neutropenic patients with hematological malignancies.
abstract: BACKGROUND
  During febrile neutropenia in only 30 to 60 percent an infectious agent is identified. This diagnostic gap could hypothetically be reduced with the broad implementation of molecular detection techniques like PCR, which has revolutionized the detection of infectious diseases during the last two decades.
  
  
  RESULTS
  We performed a longitudinal prospective study (N = 81) of neutropenic patients to assess the role of respiratory viruses in neutropenic fever and to determine the clinical relevance of blind screening for these viruses. Respiratory viruses were recovered in 14% of the patients prior to neutropenia. In 13% of neutropenic patients without fever and in 19% of those with fever, a respiratory virus was detected. Comparing different sample types; nasal swabs performed significantly better (16/117 = 43%), than throat swabs (6/106 = 6%). Throat gurgles did not show significant differences from the latter sample types.
  
  
  CONCLUSIONS
  Blind diagnostic screening for respiratory viruses before or during neutropenia is not useful. Nasal swabs are sensitive and practical option for screening on respiratory viruses.
authors.affiliation: Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. R.R.Jansen@olvg.nl
authors.forename: Rogier R
authors.initials: RR
authors.lastname: Jansen
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Biemond
authors.forename: Janke
authors.initials: J
authors.lastname: Schinkel
authors.forename: Sylvie M
authors.initials: SM
authors.lastname: Koekkoek
authors.forename: Richard
authors.initials: R
authors.lastname: Molenkamp
authors.forename: Menno D
authors.initials: MD
authors.lastname: de Jong
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Visser
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D064147:Febrile Neutropenia / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000821:virology; D010614:Pharynx / Q000821:virology; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology